Last year I wrote about the cognitive dissonance between the marketing materials produced by Rogers Memorial Hospital, in Oconomowoc, Wisconsin, and its actual therapeutic programs and practices.
That post produced a letter from Rogers' CEO himself, complaining about my "airing my grievances in a public forum" rather than talking directly to him about them.
Dude, that's what blogging's all about. Besides, I can imagine how open he would have been to my criticisms. Yeah, right.
This time around, I'm not just writing about presentation. I'm writing about practice, therapeutic practice as it's being executed at Rogers. And it stinks.
It seems that Rogers has changed its practices around the use of feeding tubes for anorexic patients. In the past, feeding tubes were considered something of a measure of last resort, sometimes necessary to save a life but something to be avoided when possible.
Not anymore. And not only that: feeding tubes are being used to keep patients at Rogers when parents want to bring them home.
Case in point: A family whom I'll call the Smiths, whose young adolescent daughter was admitted to Rogers a few weeks ago. The family was told the girl must have a tube, and although they weren't in favor, the tube was administered. Fast forward 10 days or so. Rogers is telling the family the girl has made "little progress" and urgently needs admitting to its 30-day residential program. Family can get no information on why so little progress has been made, even with the tube. Family has been researching, and has decided they want to use family-based treatment, the Maudsley approach, to help their daughter. Family tells Rogers of their intentions and asks when daughter may be safely transported home.
Next thing family knows, their local county department of child protection services is threatening to remove their daughter from their custody if they take her home. Rogers continues to insist that daughter cannot be moved so long as she's on the tube. Family says most girls with their daughter are also on feeding tubes, which constitutes a large shift in treatment protocols at Rogers.
The girl is eating. She's terrified. She wants to go home. Her family wants to bring her home for FBT. Rogers, which claims that it incorporates some FBT in its therapeutic protocols, is playing dumb and insisting that FBT would constitute child abuse and that the girl cannot safely be sent home.
The therapists at Rogers are (or should be) familiar with the studies on FBT, which show that it is very successful for adolescents under 18 who have been sick for less than three years. (It's been successful for others, too, but there are no studies yet on those populations.)
Their actions in this case and others are deeply disingenuous. Feeding tubes are a necessary evil at times. But families should be the first line of treatment and support for adolescents--especially when the family is committed to the task of helping their child recover.
Shame on Rogers.
38 comments:
This isn't limited to Rogers, however. My friend (who I met in treatment) was hospitalized in high school, and was compliant and gaining weight and just wanted to go home. Her parents saw no reason why she couldn't- she was medically stable, willing to set a contract for weight gain, etc. The hospital found out and said that she would be taken from her home if her parents discharged her from the hospital AMA. And if you leave AMA, insurance doesn't pay. So she stayed in the hospital for 3 months.
I think it's an institutional lack of understanding of ED treatment at work here. I've been to Rogers and I'm no fan. But they're hardly alone in their thinking. That being said, I also know people who have done well after Rogers, and who have had very different experiences.
Wow, that's just...awful. And unbelievably sad. It's not as though this family is denying that their child is ill. They've DONE THEIR HOMEWORK on the disease and found a treatment supported by ample scientific evidence, not some kooky pie-in-the-sky fad, which says to me (and SHOULD say to Rogers!) that they're involved, caring parents who want to do right by their child. Unless their child is seriously medically compromised and in need of inpatient medical care (which, if they're advocating a move to a residential program, is likely not the case), this hardly constitutes abuse--the parents are simply exercising what SHOULD be their RIGHT to make a decision, based on good information, about treatment OPTIONS.
This is just...outrageous. I feel so sorry for this family...and hope they manage to resolve this insanity soon.
I found the adult women residential program to be very beneficial. It was the 5th program I was in, and I am still doing well 10 months after discharge. I thought the MDs and staff were outstanding.
Perhaps there is a difference in the IP/residential, adult/adolescent programs?
Anon,
It sounds like this admission was intended to medically stabilize the patient, not for long term AN treatment. If they aren't able to get the child progressing after over a week, even though she is complying and she's tubed, then there is something wrong. A second opinion is in order, at a minimum, since they can't accomplish that.
I'm mystified not only by the apparent incompetence, but at the attitude toward the family that has entrusted their daughter to Rogers care. I wish this family well and have a lot of confidence in them and the professional team they are lining up to help their daughter post-discharge.
I have a friend who went through Rogers adult program at 19 years old, after a 4 year battle with anorexia. She went in with anorexia, and she left with anorexia. Several years later she still has anorexia.
The parent who wants to remove their child from rogers, have they considered contacting University of Chicago and having her transferred there? They do inpatient stabilization on a medical floor of the children's hospital.
Sadly, that's the norm. My daughter was in an eating group with a number of young women who'd been through Rogers for anorexia. They were all still quite ill after being discharged.
The parents are aware of University of Chicago. The problem right now is that they cannot take their daughter out of Rogers, or they'll risk losing custody.
This is a good post of your experience. Please post short summary your review and/or a link of the review on rogers memorial hospital under our website: http://www.ushospitalfinder.com/hospital/Rogers-Memorial-Hospital-Oconomowoc-WI
It will help our users and they research information about rogers memorials hospital
The family should retain a lawyer and go to court for an order directing Rogers to release the daughter to her parents so she can get better care. The lawyer would probably arrange for a qualifified expert to testify on their behalf that Maudsley is not only a reasonable alternative, but the one with the best evidence to support it. After winning in court, the parents should go to the media and a story should be plastered all over newspapers, radio, TV and Internet about what Rogers has done. It should not be difficult to find a lawyer who would handle the case pro bono, if necessary.
This is off topic, but I just wanted to say thank you for the wonderful comment you made today at the NYT. It didn't appear many readers had considered the downsides of negative stories of fat children, trying to motivate them to adopt healthy diets and lose weight, until your note. By calling parents' attention to the potential harms of heightening body weight and eating issues, you helped so many young girls and made a difference in their lives. Sandy
Thanks, Sandy, but I don't see any awareness at all in the comments that followed mine. Just more of the same claptrap. :-(
As having close experience is Rogers Memorial, I must say the staff is untrained and the therapists are burned out. They don't care about their jobs and they don't care about their patients. It's the most unethical practice I have ever seen and this woman is absolutely right- feeding tubes are the norm. Rogers is all about the money and so many times people will leave the program and come right back. Don't eat? Hey, have a feeding tube. Doesn't work- okay, go residential. MONEY MONEY MONEY. Yes, the program has worked for some but it has worked a lot less for others. I have no respect for this place.
Unfortunately, this is happening all over the country. I have been suffering for about 20 years trying to beat anorexia and my last ip stay, every patient under 18 was put on a feeding tube within a week of admittance. I have unfortunately been through this facility in MA before, and it has never been so prevalent. I asked about it (I'm in my 30's) b/c I couldn't understand the logic and I was told it's insurance - get them in, get the weight up, and get em out. Send them to resi if they need more treatment.
I refused a tube back in 2005 and was kicked out for noncompliance. I would understand it if I were not eating 100% or following all advice. They said may as well try the tube and see if your weight goes up. Um. No. I'm not getting a tube as an experiment. Damn it. Find the cause, not the symptom for me. Passing out despite eating 100% does not mean a tube is needed.
ED treatment across the nation is really suffering- I don't think it just applies to RMH. Maybe it would be worth trying to apply to RMH and improve things there rather than just complain about what is clearly wrong with it- I agree that things are seriously not right!!!
As more and more treatment centers get shut down around the country due to the economoy, we all need to figure out ways to improve the ones that are still here because treatment is needed for many.
I was at Rogers in residential for almost a year who had NOOOO problems treating me as long as my very generous insurance company paid them lots of money. I left worse than when I went there in 2008. I was discharged in the middle of trauma work at 10pm to a hotel and deemed "untreatable" once my insurance cut out. No discharge planning, nothing. I ended up in their inpatient program less than 2 weeks later in a condition where my insurance was once again obligated to cover and they kept me for 2 1/2 months. Insurance looked as though they were pulling out again so instead of making the same mistake as the first time, they discharged me to another facility where I stayed another few months and left because they were threatening to kick me out every other week. I stayed in outpatient for a couple of months and once again was returned to inpatient at Rogers after a suicide attempt and again needing treatment for the eating disorder. This was about a month and a half ago and when they discovered that my insurance had dropped me completely Dr. Weisenell initiated a court order that was a thousand kinds of unethical. I went there VOLUNTARILY but if I were under a civil commitment, the state would pay them. Right? Wrong. They are a private facility and WI wasn't willing to pay them as much as their greedy company wanted so Weisensell changed her tune and went from telling stating that I was in "immediate danger because of the eating disorder and needed intensive long term treatment" to saying that my PTSD and self harm behaviors were in more pressing need of treatment so she could justify having me escorted to just the general mental health facility that is just a holding cell. It doesn't treat anything in particular, you don't see a therapist, but her word was golden so she had the feeding tube pulled after being there for a month on it and 2 sheriffs showed up and hauled me off to county that afternoon. Most of my trauma is the result of 2 police officers. She knows this but it didn't matter. They weren't getting paid so she convinced a judge that I was kuku for coco puffs but suddenly my eating disorder didn't need to be treated and now I am sitting here not only with a feeding tube in outpatient but being RETRAUMATIZED by the whole ordeal that didn't have to be that way. And Dr. Weltzin who has been my doctor for almost 2 years won't see me anymore at his outpatient practice because Rogers doesn't want any of their employees having anything to do with me just to make sure that I don't get sent there again. Oh and by the way Dr. Weisensell who was just recently selected to head the inpatient unit last fall is now being asked to leave...hmmm. Perfect timing. Wonder why. I am so disappointed in that facility. The residential program has some incredible staff members there and my therapist there was fantastic and she was very upset when I had to leave because on the financial side of things I was just wasting a bed there so administration refused to work something out with me. She actually cared. Oh yeah, she quit shortly after I left because they don't know how to treat their employees and not burn them out.
Shame on Rogers is right.
I wish I knew then what I know now about Rogers. My son went to Rogers grateful for the love & support of his family and came home blaming and hating his family for EVERYTHING and is more isolated and depressed than ever. I thought we were all on the same page with ED in that no one is to blame. I trusted my son to the "professionals" and they let our family down! He was also encouraged to leave his treatment team of 3 years. Everything you read about any type of recovery tells you NEVER to make those types of changes right away. His therapist at Rogers joined the ED and all the lies and manipulations, again these "professionals" should have seen through it and instead of rising to the challenge they took the easy way out and validated the blame and believed the ED. I talked with his therapists and Dr. Weltzin about our concerns, as did his treatment at home because they saw the warning signs and NOTHING was done. Rogers had the input of therapists, doctors, psychiatrists & nutritionists telling them they were not accurate with their evaluations/observations and NOTHING changed. They told my son that because he was going to be 18 he no longer needed the Maudsley Approach and once he was 18 he could do whatever he wanted. This approach saved my sons life and got him into Rogers!!!
There is much more, but sharing this is very upsetting. I hope it will help someone else. We would do anything for our children and we believed Rogers felt the same way ...
I am so sorry this has happened to you.
I went to Rogers twice in 1998-1999. To make a long story shot, I am reovered, have had no relapses since then and thankfully have my health, my marriage, and now 2 wonderful little boys! While I thank Rogers for the assistance and support of some staff which aided in my recovery, Rogers itself was completely disfunctional while I was there and I think I still have some trauma issues from being there. The Medical Director while I was there was sexually involved with an adult patient, and many staff and patients were aware and voiced concerns and it was swept under the rug. This seriously jepordized the treatment of many and was unethical. He was made to resign and the case was brought to WI Licensing Board.
I also felt at the time that ROgers was very focused on the money and in the middle of treatment patients were more focused on their insurance and finances than treatment. Rogers had no problem arranging meeting at Park Bank for loans for patients to sign (which needs to be a competent decision) then stating that they were incompetent and in that there eating disorders were talking. There seemed to be alot of hypocrisy which is really sad.
Again, I wanted to get better when I entered the second time, I stood my ground, voiced my opinions, and did what worked for me with the guidance of a few I trusted. There were people who aided in my recovery but I overall I felt that the place generated dependece with no aftercare and poor discharge planning, and the challenge by choice philosophy they claimed was present unless they disagreed with you...then you were an eating disorder talking with no insight into yourself. I hope it has gotten better!
I personally had a very positive experience with Rogers (was on the 1st floor last summer), and wanted to let anyone who stumbled upon this page before going there know that. The vast majority of the people who I went to treatment did, as well. It seems the "make it or break it" of treatment is your own attitude- if you go in there at your rock bottom, ready to fight tooth and nail to give your ED the boot, things tend to go a lot better than if you're fighting the system. I know, easier said than done. But Rogers and (most of) the staff there were an incredible aid for me to begin my journey into recovery. I struggled with my insurance company and had to fight tooth and nail to stay the entire time, which seems to be the opposite fight that a lot of you seem to have fought, but I don't blame that on Rogers in my case. I also don't know much about their use of feeding tubes- they didn't seem to over-use them on my floor but that could have been because I wasn't on the younger floor.
First when you go to the web-site for Rogers remember they have a company do the review that really knows nothing about the hospital. Last year (2011) we had our son admitted twice to the Oconomowoc Facility and both times were a complete failer. The first time he was admitted he was in detox for 5 days and then released into a so called intense outpatient program through Partners in Behavioral Health (separate from the hospital but they lead you to think other wise), we thought it was helping until we noticed the signs of using again, he went day after day week after week to the counseling totally under the influence of heroin,with his eyes rolling back in his head and they said and did nothing and this went on until the insurance ran out and then let him go. The second time was detox and out. I have a co-worker who says he went basically through the same thing with his sister 5 years ago with the same result. I am not saying the failer was 100% the hospital because to get help you have to want it. But to let something like this go on and on is unexceptable. I guess what I am saying is look around for a good facility or hospital that was recomended by word of mouth and not some web-page desined to draw you in with questionable statments at a very desperate time in your life.
Well, I am going to Rogers for the residential adult program for eating disorders in June. I have finished my admissions process... I am from Canada, and thankfully my OHIP will completely cover my entire stay there so I have no financial burden. In all honesty, I believe totally ripping apart a treatment center is extremely negative. In Canada our resources are literally slim to none, so much so that the beds are limited to those with BMIs that are knocking on death row. My BMI is 16.1 and I have been denied from THREE different programs because it is considered "too high"... If anything, people here should be grateful for the help that is available and utilize it to the highest extent possible. I feel like after reading this it has given me such a negative outlook and my Ed is fighting me telling me not to go. However I am not going to fight these negative comments, and prevail through this process. I REALLY think a lot of it has to do with people fighting the system. You need to want this more than anything to get rid of it
I worked at rogers years ago and I quit. We had a long term committed Schizophrenic pt who was treated extremely poorly by one of her 24 hour caregivers leaving her in wet briefs often his entire shift. My complaints of his lack of empathy for the pt went unlistened to as the aide was the spouse of an administrator. That combined with the directors calling various Drs to coax pts to enter the facility when the census was low was unethical beyond belief.
Was looking to go there but sounds like I'm better off on my own. I don't need any more trauma from healthcare providers. Feeding tubes really to threaten girls....wrong.
Where's a good place to go.....40 yr old here in WI
Anon, I wish I had some advice for you. Maybe someone else will.
I am currently looking to get into treatment. I've heard good reviews from people on my blog about Rogers but decided to look further. This really is disturbing to me. It worries me that I will go to Rogers as suggested by my therapist and things will only get worse. Thank you for sharing this. It is making me rethink going to Rogers.
I have NO idea how in the world this place is rated in the "Top 5" in the country. Their intake process sucks (to be nice), and they play games with you. When you're already depressed and begging for help, they refuse to accept you if you have anything else wrong with you or if you say any of 25,000 mystery "red flag" words. They say they'll call you back, and they don't. They say they're trying to get you into the program, and they're not. All you're told is that "Dr. Blah-Blah" thinks you don't qualify. You never get to meet or speak to this great mystery person. Only his minions will deliver the news. And even the nursing staff will back-stab you in a heartbeat!! You'll be held hostage in the lock-down unit, even if you aren't suicidal or a drug addict. They don't care. And be careful if you do get into the program -- they report you if you have any behavior they don't like (i.e. inability to focus due to ADD, nervousness due to anxiety, or crying due to talking about tough stuff). Honestly? Read a book or talk to a friend and save yourself thousands of $$$ and wasted weeks. Another blogger was completely correct - their advertising about their fancy new buildings and wonderful programs doesn't match what you get or see on the inside.
Dear "Anonymous" who posted on 7/21/12 -- RUN FAR,RUN FAST FROM THIS AWFUL PLACE. I've been there and it makes "One Flew Over the Cuckoo's Nest" look like a day at the spa. The doctors are never there but issue orders from on high, having never met you personally. Awful, awful place. And they won't release you until you figure out the magic words to say/not to say.
I know this comment comes months after Anonymous posted on 7/21/12 looking for a treatment center, but I can only post now and hope that she - or anyone else who needs help - may come across this comment and find some hope.
I'm 20 years old and am finally finishing up with treatment after going to some sort of daily therapy for over a year. I went to Rogers a few months ago - not to their ED program - and had great success with it. However, my ED treatment began at Timberline Knolls in Lemont, IL. TK is known for treating co-occuring disorders, so they won't turn you away for having "too many" or "conflicting" issues. They specialize in it all. The staff there is incredible, and they mean it when they say that they meet their residents where they're at upon entry into the program. I didn't have any desire to get better when I got there a year ago - in fact, I denied that I had ED for 2 months until I got the courage to speak honestly to a staff member I had grown particularly close to. The relationships I formed with girls there were absolutely incredible and so meaningful, and I remain in contact with most of them to this day. The staff, again, was so genuine, and some of them had even been in recovery themselves for years, so they could relate to residents on another level. The three months I spent there were hard and trying, but I cannot even begin to tell you how worth it they were. I went to TK, ready to give up on life, and because of that program, along with a couple aftercare programs, I am ready to embrace life and all that comes with it. I feel hope, gratitude, and pride again.
My daughter is currently at Roger's and is on her 10th day there with anorexia nervosa. My wife and I have seen little progress in her and she seems alone and scared. Ten days there and the social worker has not met with her once yet! Additionally, the doctor there speaks so fast and in circles, he is almost impossible to understand his point. Today my daughter called my wife is now having suicidal thoughts. Certainly something she has learned by sharing residence with suicidals, cutters, burners and ADHD patients. I have been trying to speak with a doctor today and no luck after six hours of calling and leaving messages. My God, this is my daughter in their care and I can't get any information on her progress or when she may be released! I will follow up on this blog with any progresss, good or bad. Praying for good though.
My daughter is currently at Roger's and is on her 10th day there with anorexia nervosa. My wife and I have seen little progress in her and she seems alone and scared. Ten days there and the social worker has not met with her once yet! Additionally, the doctor there speaks so fast and in circles, he is almost impossible to understand his point. Today my daughter called my wife is now having suicidal thoughts. Certainly something she has learned by sharing residence with suicidals, cutters, burners and ADHD patients. I have been trying to speak with a doctor today and no luck after six hours of calling and leaving messages. My God, this is my daughter in their care and I can't get any information on her progress or when she may be released! I will follow up on this blog with any progresss, good or bad. Praying for good though.
Anon, I strongly encourage you to take your daughter out. If you can't get anyone to talk to you that's reason enough. Where are you geographically? Check www.maudsleyparents.org (go to the Treatment Finder) or the NEDA website for some other options for care.
I was admitted to Rogers about a year ago for OCD and I was very displeased with the quality of my stay. There was limited communication throughout my stay between members of my treatment team which results in many misunderstanding, misinformations, etc. I had been in therapy prior to admission and was very close to that therapist. I had been diagnosed with an attachment issue and Rogers cut me off from that therapist as a way to "fix" my attachment issues. They never even talked to my therapist. They did not send a discharge summary until 3 months after I was discharged and my psychiatrist didn't even sign it. My professionals made promises to me that they broke, they were not respectful of my personal belongings, they were inflexible, and they outright lied to me when I asked about the credentials of my treatment team members. The entire stay was a huge manipulative joke and I came out feeling worse than when I was admitted. Sure my OCD was better but the rest of my life was in pieces.
I'm so glad that there are other people who were displeased with the place. It seems to me like there are only good reviews out there that I've seen so far and it bothers me. I don't know how they can rank themselves so highly. I keep in touch with almost all of the people who were on my unit when I was there and half of them have already relapsed. It's disappointing that a place with such a "good reputation" can't make more of lasting positive difference on people's lives.
The same thing happened to me back in 2009 when I was there.
My first night, I was terrified of being there. I hadn't eaten in a week, so naturally my first meal I refused. They gave me the option to take an ensure, and I DID THAT. But then an hour later, I'm being called into the office they have, and they're telling me that they're putting a tube in me because it would make my treatment go by faster. Umm? They FINALLY got my parents to agree even though they STRONGLY didn't want me to have it. I was actually TRYING... it wasn't like I was refusing everything. And they scarred my 12-year-old self! I was being thrown into a treatment center, having to eat for the first time in a long time, drinking an ensure, and despite my efforts, STILL given a tube. It was A LOT to take in on my FIRST day...
Rogers is consistently understaffed and there is a very high turn over of staff. That never bodes well for a program. If you read their website, there is often misleading advertising. Their research on success rates is skewed and completed invalid. Eating disorders are difficult to treat and need the staff to accommodate that.
Anybody try Timberland Knolls?
Does anyone have an opinion of their treatment at the Tampa facility.
I worked there several years and the staff try, but there isn't a solid support from leadership to build a program that works. Their adolescent unit manager is a joke with no real understanding of clinical management so there isn't any real treatment going on just babysitting and feeding the kids. Staffing is left up to archaic numbers to justify budgets instead of outcomes. Those of us who out our all into it were left burned out and unappreciated. I just hope despite that, some kids used our help. We tried, and we did try to speak up but when a company is too busy expanding than looking at the quality of their care, people suffer.
Harriet, you continue to inspire and inform. We only wish that we had read this blog before admitting our daughter to Rogers in Nashville. The program is a sham. In fact, they continued billing us, after our insurance would not cover, knowing that we were unable to pay. We also have a malpractice situation that I cannot speak about publicly due to pending legalities. But let me assure everyone reading this post. I know how desperate you can get as a mother/father when you want to save your child. You will do anything. But that doesn't include giving someone full access to your child without your present. The staff at the Nashville location try to avoid the parent at all costs. We learned most from our daughter. Thankfully she shared. And they will treat your child for something that they don't have - which to us implied that they are using them as an experiment. Oh, the information I could share if I could here publicly. But not now. Please find a recovery team and work with them while your child is at home. That's the best way. These hospital facilities are mills. They admit children and don't do half of what they advertise. They pay on your emotions. AVOID ROGERS. We met a man in the lobby one day who told us that his daughter had been in the program at Rogers for 2 years. Nothing has changed. I wanted to ask him why the heck he was still there. Cash cow! Rogers is NEVER going to admit that they are unable to help someone. They will suck every dime out of you. Sorry...now I rant. Excuse me. Love your children. Love them enough to find them personal care with your active involvement. God bless you .
So glad to have a place to write this. My son who we adopted several years ago has been seeing a psychiatrist for 8 months for ADHD, and ODD My son also has anxiety from early childhood abuse. Our psychiatrist told us about Rogers program for anxiety and I called yesterday. Today I had an intake appointment on the phone with Rogers for about an hour to give background on my son. About an hour after I got off the phone the local sheriffs department and child protective services arrived to conduct an investigation. They repeated verbatim some of the issues I had told the intake person at Rogers about my son. I called the intake person back and they admitted to reporting my son. We have had varied and extensive therapy since adoption 8 years ago. But to have all the sensitive information about our son given to Rogers and then sent directly to the sheriff was a shock. I called the psychiatrists office who referred us to Rogers to let him know what happened. We were seeking additional therapy, this seems like very unprofessional behavior. The case is closed with the sheriffs office we have extensive records of all the services we have gotten for our son over these 8 years. But there is still a record now of us being reported, and a sheriffs car in our driveway for several hours.
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